Author: Zhengxiao Zhao (Liuzhou Hospital of Traditional Chinese Medicine) Yana Wu (Hunan University of Traditional Chinese Medicine) Department of Hepatology, Liuzhou Hospital of Traditional Chinese Medicine Zhengxiao Zhao In the early stages of human history, since there were no medical and pharmacological theories, people used the substances available around them by instinct or experience to prevent and treat diseases, so they were only called drugs. Later, with the birth of medical theories, pharmacological theories were formed by using them to guide the use of drugs, so each pharmacological theory is actually a part of its corresponding medical theory. The understanding and use of Chinese medicine is based on the theory of Chinese medicine, with a unique theoretical system and form of application that fully reflects the characteristics of our history, culture, and natural resources. The formation and development of the pharmacological theory of TCM can be traced back as far as the Qin and Han dynasties, and came into being with the formation and development of the entire theory of TCM. The four qi, five tastes, toxic and non-toxic, and dispensing laws of Chinese medicine established during the Qin and Han periods of the Warring States laid the prototype of the theory of Chinese medicine. The theory of the return to the meridian and the theory of the rise and fall of the floating sink formed during the Jin and Yuan dynasties enriched and developed the content of the theory of Chinese medicine, and the ensuing “pharmacology of the law” reflected the profound influence of philosophical thinking in the interpretation of the theory of Chinese medicine. The progress in understanding the efficacy of Chinese medicine and the gradual establishment of the efficacy system in the Ming and Qing dynasties established the basic structure of the theory of Chinese medicine with the four gases, five tastes, the attribution, the elevation and sinking, the toxicity and non-toxicity, the efficacy, the relationship between the combination, and the contraindication of the combination as the core. The development of Chinese medical science is a slow and gradual process. As early as the period of the Yellow Emperor’s Classic of Internal Medicine, the theory of Chinese medicine theory was basically formed, but so far, no work used to explain pharmacology at that time has been found to be published. It is reported that there was a book “Tongjun Caiyao Lu” in the ancient times, but it is not known whether there is any content related to the theory of Chinese medicine in it. The Southern Song scholar Zheng Qiao in the “General Zhić»Insects and Herbs” said: “Most Confucian families do not know the things in the field, agricultural and nursery people do not know the purpose of the book of poetry, the two are not combined, so the birds and animals, herbs and trees do not spread. But the herb family, human life, all those who learn it, it is important to know the real, not just seek to say than other books.” In ancient times, most of the medical practitioners were Confucian students, the most profound influence of Confucianism in medicine, so later there is a “Confucian book a load, the medical book a head” of the saying. Due to the special nature of the medical profession, it was not possible for practitioners to grow their own medicine (even if they did, it was only a small number of varieties suitable for local cultivation), and practitioners were unable to understand in detail the growth, cultivation and harvesting of drugs, and even more so the form, smell and characteristics of drugs, so in the ancient times when Chinese medicine was completely integrated, the theory of Chinese medicine was easier to form, while in later times As the division of labor in all walks of life became more refined, the development of Chinese medicine theory was difficult. After the formation of the prototype theory of Chinese medicine, it has not been able to truly guide the clinical practice of medicine. Section I. Pre-Qin to Han dynasties: laying the foundation of the theory of medicinal properties It is still a mystery when the basic theory of TCM began to take shape. In terms of extant medical writings, the earliest theories of medicinal properties in Chinese medicine can be traced back to two classical works of Chinese medicine, the Divine Husbandman’s Classic of the Materia Medica and the Yellow Emperor’s Classic of Internal Medicine. Although the Book of Han and the Art and Literature contains seven medical scriptures, only one work, the Yellow Emperor’s Classic of Internal Medicine, exists. The Yellow Emperor’s Classic of Internal Medicine, written during the Spring and Autumn and Warring States Periods, is the earliest surviving masterpiece on the basic theories of Chinese medicine with a complete and rigorous system, which is a theoretical summary and sublimation of pre-Qin medical practice and still effectively guides the clinical practice of Chinese medicine. The Yellow Emperor’s Classic of Internal Medicine not only summarizes the basic theories of Chinese medicine in a comprehensive and systematic manner, but also provides the theoretical basis for the exploration of the theory of medicinal properties and the clinical application of drugs. The theories of medicinal properties directly discussed in the book include yin and yang, cold and heat, five tastes, five odors, five colors, toxicity, tonicity and diarrhea, etc. The medicinal properties theories developed in later times, such as elevation, floating and sinking, attribution to the meridians, moistening, dryness, urgency and lightness, etc., can find their origins in some of the treatment rules and other treatises of the Yellow Emperor’s Classic of Internal Medicine. Although the Huangdi Neijing has elaborated on the principles of drug application, it has not discussed specific drugs. The first work to give a preliminary account of the pharmacology of drugs was the Shennong Bencao Jing (Divine Husbandman’s Classic of the Materia Medica), which was written at the end of the Eastern Han Dynasty (around the 2nd century AD). In the “Shennong Ben Cao Jing”, the main contents of the theory of medicinal properties are the four gases, five tastes, toxic or non-toxic, yin and yang attribution, etc.; in the harvesting and production of drugs, there are theories such as harvesting and treatment time and month, dry and dry, raw and ripe, the land out, true and false, new and old, suitable for pill and loose ……. In terms of drug classification, in addition to the classification of drugs into upper, middle and lower classes according to their goodness and toxicity, there are also records of cold drugs, hot drugs, vomiting drugs, sore drugs, rheumatism drugs and other drugs classified according to their functions. These discussions undoubtedly played a role in the recognition, application and deeper understanding of the medicinal properties of Chinese medicine at that time and in later generations. Although these discussions are relatively simple and rough, they are, after all, the earliest origins of the theory of medicinal properties. It combined the functional utility of drugs in medical practice with the medical theory of the time for theoretical discussion and explanation, so that people gradually developed from the empirical use of a single drug to the combination of drugs after theoretical analysis, that is, the clinical use of the so-called medical prescriptions in later times, and gradually rose from experience to theory, which played a great role in the clinical prevention and treatment of diseases for the Chinese people. The Yellow Emperor’s Classic of Internal Medicine summarizes the medical experience before the Qin and Han dynasties and establishes a relatively complete theoretical system of Chinese medicine, using the ancient simple dialectic and materialistic ideas – the theory of the five elements of yin and yang – to explain human physiology, pathology and treatment. The book is not a monograph on pharmacological theory, but the theories of yin and yang, qi and blood, meridians, viscera, hidden images, tonic and diarrhea, ascending and descending discussed in the book, as well as the basic theories containing the characteristics of thinking such as the correspondence between heaven and man, hyper-evil commitment and treatment, are not the basis of pharmacological theory, which involves the content of the theories of five tastes, cold and heat, return to the meridians, five organs and bitter desires, such as tonic and diarrhea, are the basic contents of pharmacological theory. The Yellow Emperor’s Classic of Internal Medicine initially summarizes the nature of drugs, matching the five tastes with the five organs, five colors and five odors, and using the theory of yin and yang to summarize the five tastes and other properties. For example, “pungent and sweet is Yang”, “sour and bitter is Yin”, “Yang is Qi, Yin is taste” and so on. It also connects the medicinal properties with the luck of the year, the five directions, the five preferences and the five excesses, showing a more complex level. The combination of drugs has the division of ruler and minister, and the combination of five flavors has the difference of treating six diseases. For example, “wind is in the interior, the treatment is pungent and cool, accompanied by bitter, with sweet to slow it down and pungent to disperse it.” These theories related to pharmacological theory have laid the cornerstone for the formation of the theory of Chinese medicine, and have played a major role in guiding the clinical use of medicine. In terms of the content of clinical pharmacology, they are mainly reflected in: (1) The theory of odor and yin and yang and the doctrine of transformation of odor and form and essence The doctrine of yin and yang is one of the core elements of the basic theory of Chinese medicine. Yang is qi and yin is taste. Taste returns to form, and form returns to qi.” According to Chinese medicine, our usual medicine and food can be divided into a tangible part and an invisible part. Among them, the tangible part is expressed in the form of “taste”, so “yin is taste”; while the invisible part is expressed in the form of “qi”, so “Yang is qi”. Because “taste” comes from the tangible part, “taste” enters the body and seeks the same quality, so it combines with the form and can nourish the form. And because “qi” actually comes from the tangible part, the tangible medicine and food can nourish qi. “Yang is qi, yin is taste; taste returns to form, form returns to qi; qi returns to essence, essence returns to transformation; essence eats qi, form eats taste.” These basic ideas of the theory of transformation of odor form and essence had a great influence on the formation and development of traditional Chinese medicine, and laid the foundation for the pharmacological theory of odor in traditional Chinese medicine. The Su Wen (The Great Treatise on the Supreme Being) also elaborates that the five tastes and the quality of medicine are the main material basis for the efficacy of drugs and food: “What are the uses of the five tastes and yin and yang? Said: pungent and sweet dispersal for Yang, acid and bitter Chung drain for Yin …… or dry or moist, or soft or firm, to the benefit of the line, to regulate its gas to make it flat also.” The Nei Jing also categorizes the smell of medicine and food as yin and yang. The Su Wen – Yin Yang Ying Xiang Da Lun points out that: “Pungent and sweet to disperse for Yang, acid and bitter to surge and drain for Yin; salty to surge and drain for Yin, light to seep for Yang.” This article proposes: because taste is tangible and yin, gas is invisible and yang, so “thick taste is yin, thin is yin of yang; gas is thick is yang, thin is yin of yang. Taste is thick, thin is ventilated; gas is thin is ventilated, thick is heat.” Later Liu Wansu has further deepened this, he cited evidence that “the appendage gas thick, Yang in Yang; rhubarb taste thick, Yin in Yin, Poria thin gas, Yang in Yin, so conducive to urination; ephedra taste thin, Yin in Yang, so sweating.” These statements reflect the idea of classification of drugs and food according to the thickness of smell and taste differences. (2) medicine and food five elements and five flavors said five elements is an ancient Chinese view of material movement. According to the Five Elements theory, nature is composed of five elements: gold, wood, water, fire, and earth. With the prosperity and decline of these five elements, nature is constantly in motion and changing, which not only affects the fate of human beings, but also makes the cycle of everything in the universe. The earliest book in the existing literature that discusses the theory of the five elements is the Shangshu. Shang Shu Hong Fan” contains: “five elements: one is water, two is fire, three is wood, four is gold, five is earth (Chuan: all its birth number). Water is said to run down, fire is said to inflame the top (Chuan: said its natural constancy). Wood is said to be straight, gold is said to be from the leather (Chuan: wood can knead straight, gold can change). I love the earth to harvest (Chuan: the seed is said to crop, convergence is said to harvest, the earth can be planted, can convergence). Run down for salty (Chuan: water brine born), Yan up for bitter (Chuan: the taste of burning gas), curved straight for sour (Chuan: the nature of wood real), from the leather for pungent (Chuan: gold gas), crops for sweet (Chuan: sweet taste born in all grains).” In this way, the five elements doctrine will constitute the world of matter, according to its different characteristics into five categories: with growth, rise, strip, Shu Shu, etc., the role or nature of things belong to wood, with warm, rising role or nature of things belong to fire, with biochemical, bearing, accepting role or nature of things belong to earth, with clean, surrender, astringent role or nature of things belong to gold, with cold, nourishing, downward running characteristics or Things with cooling, nourishing, downward running characteristics or properties belong to water. The Yellow Emperor’s Classic of Internal Medicine introduces the philosophical concept of the five elements into the field of Chinese medicine. Based on the materialistic view of the universe, the five elements are used to categorize drugs, to reveal their functions and relationships and to maintain the balance of the internal and external environment of the human body, and to relate everything in the world to the five elements. For example, the book “Suwen Jin Kui Zhen Shu” links the five directions, five colors, five organs, five orifices, five tastes, five categories (five elements), five animals, five grains, five stars, five sounds, five numbers, five bodies, five odors, etc., reflecting the view that things are universally connected: “The green color of the east is in the liver, opens the orifices in the eyes, hides the essence in the liver, its disease is frightening, its taste is sour, its class is grass and wood, its animal is chicken, its grain is wheat, its response to the four seasons. Its grain wheat, its should be the four seasons, the upper as the star of the year, is the spring qi in the head. Its sound horn, its number eight, is to know the disease in the tendons. Its stench.” “South red, into the heart, open the orifice in the ears, hide the essence in the heart, so the disease in the five organs, its taste bitter, its class of fire, its animal sheep, its grain millet, its should be four seasons, on the fluorescent star, is to know the disease in the pulse. Its sound symbol, its number seven, its odor coke.” “Central yellow, into the spleen, open the mouth, hide the essence in the spleen, so the disease is in the tongue, its taste is sweet, its class of earth, its animal cattle, its grain and millet, its response to the four seasons, the upper is the star of Zhen, is to know the disease in the flesh also, its sound Gong, its number five, its odor fragrant.” “Western white, into the lung, open the orifice in the nose, hide the essence in the lungs, so the disease in the back, its taste pungent, its class gold, its livestock horses, its grain rice, its response to the four seasons, the upper for the Taibai star, is to know the disease in the skin also. Its sound Shang, its number nine, its smell fishy.” “North black, into the pass in the kidney, open orifice in the second yin, hide essence in the kidney, so the disease in the stream. Its taste salty, its class water, its animal swine, its grain beans. It should be four times, on the star of the star, is to know the disease in the bone. Its sound feather, its number six, its smell rotten.” In this way, the doctrine of the five elements was centralized, and the five grains, five fruits, five animals, five vegetables, five tastes, five colors, etc. were divided into five elements and linked to the five organs, making a significant contribution to the theory of Chinese medicine and food. In addition, there are also a lot of similar connections in the “Spiritual Pivot – Five Tastes” and other chapters. The following is a summary of the relationship between the five elements and nature, the human body, and food in each chapter: Five Elements, Five Directions, Five Seasons, Five Qi, Five Transformations, Five Bodies, Five Organs, Six Internal Organs, Five Emotions, Five Sounds, Five Tastes, Five Smells, Five Grains, Five Fruits, Five Animals, Five Vegetables, Five Numbers, Five Stars, Wood, East, Spring, Wind, Life, Tendons, Liver, Gallbladder, Eyes, Anger, Hoo, Horns, Green, Sour, Shame, Ma, Lee, Dog, Rooster, Leek, Eight Years, Star, Fire, South, Summer, Summer, Long, Heart, Small Intestine. Tongue Ear Joy Laugh Worry Che Che Bitter Mai Millet Apricot Sheep Allium Seven Fluorescent Confusion Earth Central Long Summer Wet Flesh Spleen Stomach Thought Song Retching Gong Yellow Sweet Fragrance Japonica Rice Jujube Ox Aoi Five Zhen Xing Jin West Autumn Dryness Harvest Skin Hair Lung Large Intestine Nose Grief Cry Cough Shang Bai Xin Fishy Yellow Millet Rice Peach Chicken Horse Scallion Nine Tai Bai Water North Winter Cold Hidden Bone Kidney Bladder Ear Two Yin Fear Moan Chestnut Feather Black Salty Rot Soybean Chestnut Pig Patchouli Six Star of the Year